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From the file

Test and trace | How test and trace became a national disaster

A shot in the dark

Thursday 8 October 2020

The prime minister is reaching for the stars, but the test and trace scheme is still in the gutter


Wednesday 9 September was a bad news day for the UK. The night before, AstraZeneca announced that trials for the Oxford University Covid vaccine – one of the most advanced and promising vaccine candidates in the world – were on hold after one of the participants fell ill. Cases across the country were up following the reopening of schools and offices, and the government needed to take steps to stop their rise. That afternoon Boris Johnson, the prime minister, announced new restrictions on social gatherings; the “rule of six” was to come into force the following week.

The test and trace programme was in a sorry state too. The previous month, at-home tests had run out across England and Scotland. Booking restrictions at local test centres – aimed at lessening the pressure on overstretched labs – meant patients with Covid symptoms were forced to drive miles, sometimes hundreds, to access a test, and Dido Harding – the head of the test and trace system – had publicly apologised for the system’s inadequacies.

In the midst of this chaos, Johnson used his press conference on 9 September to dangle some hopeful news. The government, he revealed, had a plan for mass testing – a “moonshot” attempt to make quick, simple tests available at scale by next year. Even people without symptoms would be tested to confirm that they were free from infection and could go about their lives “in a more normal way”.

Taken in the very kindest light, the announcement was meant as a happy distraction, a small jot of optimism for the public after six months mired in anxiety about our health and our finances. Still, it was an irresponsible promise to make – to suggest that a return to normal life might be just around the corner when the stark reality is that the winter ahead will be hard-going.

More realistically, the announcement was designed as a diversion, concocted to distract from the government’s shambolic record on implementing its existing test and trace system.

As more details of the “moonshot” emerged, the more absurd it seemed. Leaked documents revealed the plan to roll out between 6-10 million rapid tests per day at a cost of £100bn – a figure so high that some sceptics thought it was a typo. What’s more, the government seemed to be placing its bets on a series of unproven saliva testing products and a new set of rapid antigen tests.

The plans were roundly criticised by experts in the scientific community. They said the proposals were “devoid of any contribution from scientists, clinicians, and public health and testing and screening experts,” and accused the government of “disregarding the enormous problems with the existing testing and tracing programmes.” Martin McKee, Professor of European Public Health at the London School of Hygiene and Tropical Medicine, wrote in the BMJ that the plans portrayed “a government whose ambition far exceeds its ability to deliver, and which sees governing as the practice of launching grandiose initiatives detached from any clear strategy.”

A month on, it’s still mostly pie in the sky – but not completely. The rapid antigen tests are in production: Italy is already using them at some major airports and the UK government is in talks to get hold of some, according to the BMJ. But when they do become available, the likelihood that the British government will be able to procure them at the scale needed for the moonshot seems remote. Roche, one company manufacturing the tests, estimated in early September that it would be able to make 80 million units a month only by the end of the year. Even then, the company’s entire global monthly manufacturing capacity would serve the UK’s moonshot for less than a fortnight. The plans have little basis in reality.

In the meantime, the UK is facing a second wave that looks likely to grow as winter approaches. The existing test and trace system is beset by a new scandal: 16,000 positive test results were not uploaded correctly to the system’s database, meaning that as many as 48,000 people will have failed to self-isolate after coming into contact with infected individuals. If experience is any guide, the idea that this government could competently keep track of millions more test results every day is little short of farcical.